Patient Reported Outcomes/Quality of Life

PV QA 4 - Poster Viewing Q&A 4

TU_40_3708 - Real-time Collection of Patient-Reported Outcomes (PROs) in Lung Cancer Patients Undergoing Thoracic Radiation

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Real-time Collection of Patient-Reported Outcomes (PROs) in Lung Cancer Patients Undergoing Thoracic Radiation
C. R. Elledge1, P. Han1, R. K. Hales1, T. R. McNutt1, M. R. Bowers1, C. Snyder PhD2, C. Hu3, and K. R. Voong1; 1Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 2Johns Hopkins University School of Medicine, Baltimore, MD, 3Johns Hopkins University School of Medicine Department of Biostatistics, Baltimore, MD

Purpose/Objective(s): There is increasing interest in collecting patient reported outcomes (PROs) to improve symptom management and to provide higher quality, patient-centered care. However, integrating PRO data collection into clinic workflow outside of clinical trials for cancer patients is still not routine. Herein, we report the feasibility of prospectively collecting real-time electronic PROs using the National Cancer Institute’s Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) for patients who received radiation as part of treatment for lung cancer.

Materials/Methods: Between October 2016 and January 2018, lung cancer patients treated with thoracic radiation at a tertiary academic cancer center were identified. Radiation included neoadjuvant, definitive, adjuvant or consolidative treatments. Patients answered 11 validated PRO-CTCAE questions in real-time prior to on-treatment visits (OTV) or follow-up visits. Domains assessed included: general, pulmonary, nutritional, and other symptoms. PROs were recorded electronically on tablets in clinic waiting areas. Data was transmitted into the radiation electronic health record for review by providers during routine clinical care. Compliance was defined as the number of surveys completed divided by the total number of visits. Partial compliance was defined as the number of surveys partially completed divided by the total number of visits. Feasibility was defined as a compliance rate of at least 60%. Descriptive statistics were used.

Results: Of the 295 patients identified, median age was 65 years (range: 32-90), 45% (n=132) were male, and 77% (n=227) had non-small cell lung cancer (NSCLC). Median dose was 61.2 Gy (range: 30-72) delivered in 33 fractions (range: 10-37). Most patients (89%, n=262) had more than one visit resulting in 1514 total visits. Compliance was 62% (n=940/1514 visits) and partial compliance was 1% (n=22/1514 visits). Compliance rates improved over time. During the initial three months of implementation when PROs were collected in only one provider’s clinic, compliance was 30% (n=31/104 visits). During the next 13-month period, PROs were collected from patients of all providers (n=2). Compliance in the first six months was 48% (n=331/695 visits) and improved to 81% (n=578/715 visits) in the next seven months. There were 72 patients with NSCLC (72/227, 32%) who began treatment after the initiation of the PRO data collection. On analysis of this subset, longitudinal OTV and follow-up PRO data showed an average OTV compliance of 63% (n=232/366 visits) and an average follow-up compliance of 70% (n=86/123 visits).

Conclusion: Real-time electronic PROs can be collected as a part of routine clinic care in a busy multi-provider thoracic radiation oncology clinic with an acceptable compliance rate above 60%.

Author Disclosure: C.R. Elledge: None. P. Han: None. R.K. Hales: Health Economics Advisory Board; AstraZeneca. T.R. McNutt: Research Grant; Canon, Philips Radiation Oncology Systems. Patent/License Fees/Copyright; Sun Nuclear, Accuray-Tomotherapy. President Elect; AAPM-MAC. M.R. Bowers: None. C. Snyder: Research Grant; Genentech. Travel Expenses; Optum. Royalties; UptoDate. Past President; International Society for Quality of Life Research. C. Hu: Research Grant; National Cancer Institute. Honoraria; Varian. K. Voong: Research Grant; Lung Cancer Research Foundation, Radiation Oncology Institute. Honoraria; American Society of Clinical Oncology.

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